Why I Have a Speech Pathologist on My Medical Team
Many people with Parkinson's (PWP) develop a speech and voice disorder. As a Certified Speech-Language Pathologist (SLP), I have treated many Parkinson’s patients. Speech pathologists treat speech, voice, and dysphagia (swallowing) disorders. They can also assist with cognitive changes.1
I encourage people with Parkinson's to make an appointment with an SLP for an evaluation and treatment. It is beneficial to do so even before the onset of speech difficulties occurs.
I advise my patients to start voice therapy as early as possible, even if they are not exhibiting symptoms. Although I am an SLP, I chose to work with another speech pathologist to do my voice therapy.
Speech problems
Parkinson's speech problems are characterized as being dysarthric. Dysarthria is caused by muscular weakness necessary for speech. Speech appears slurred or unintelligible to the listener.1
Parkinson’s speech problems may also include slow speech, rapid rushes of speech, decreased vocal loudness, monotone voice, and imprecise articulation. These can all impede intelligibility.1
PWP may experience difficulty using the tongue, lips, and muscles for forming sounds and swallowing. Furthermore, if the facial muscles are affected, if can lead to a mask-like look. This can make it more difficult for a listener to read facial expressions.1
What can a speech pathologist do?
Speech pathologists help people with Parkinson's speak clearly, loudly, and with intent. They help in displaying emotion with facial cues through specific exercises. Furthermore, SLPs increase word-finding abilities, can help manage cognitive functioning, comprehension issues, memory, and following directions.
Speech pathologists provide oral motor exercises to assist with speech, voice, and swallowing abilities. Speech therapy includes respiration (breath support) which controls the power necessary for speech loudness. Most PWP think that they are speaking loud enough. Their internal self-regulating mechanisms are impaired.
Therapists can help with resonance - how the air is shaped by the oral and nasal cavities. They can also help with prosody - the rhythm, melody, and intonation of speech.
SLPs may also assist with safe swallowing techniques to prevent aspiration, when food or liquid goes "down the wrong pipe." This can lead to aspiration pneumonia, which is the number 1 cause of death in Parkinson's.2
Communication programs
In my opinion, some of the best programs that SLPs use in Parkinson’s speech and voice therapy are The Parkinson Voice Project and the Lee Silverman Voice Treatment (LSVT).
The Parkinson Voice Project teaches people with Parkinson's to increase loudness and to speak with intent. The LSVT-LOUD training program teaches PWP to "think loud" and to "speak loud." This program improves and/or maintains loudness and speech clarity.
To preview these programs, follow them on YouTube. Ideally, working with an SLP is more advantageous than trying to do it on your own online.
Finding an SLP
You can find a speech pathologist who specializes in Parkinson's disease by contacting the American Speech-Language-Hearing Association (ASHA). They can recommend an SLP who treats PWP in your area.
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